As compared with paclitaxel administered every 3 weeks, paclitaxel administered weekly did not prolong progression-free survival in patients with ovarian cancer, a study published in The New England Journal of Medicine has shown.1
A dose-dense schedule of paclitaxel given weekly plus carboplatin every 3 weeks or adding bevacizumab to paclitaxel and carboplatin administered every 3 weeks has demonstrated effectiveness in ovarian cancer. Therefore, researchers sought to evaluate whether dose-dense paclitaxel administered weekly and carboplatin would extend progression-free survival compared with paclitaxel and carboplatin given every 3 weeks among patients receiving or not receiving bevacizumab.
For the study, investigators enrolled 692 patients with ovarian cancer, of which 84% opted to receive immunotherapy. Participants were randomly assigned to receive paclitaxel 175 mg/m2 IV every 3 weeks or weekly paclitaxel 80 mg/m2 IV, plus carboplatin AUC 6 IV for 6 cycles.
In the intention-to-treat analysis, results showed that median progression-free survival was 14.7 months with weekly paclitaxel compared with 14.0 months with paclitaxel administered every 3 weeks (HR, 0.89; 95% CI, 0.74 – 1.06; P = .18).
Among patients who received bevacizumab, researchers found that weekly paclitaxel did not significantly improve progression-free survival vs paclitaxel given every 3 weeks (14.9 vs 14.7 months, respectively; HR, 0.99; 95% CI, 0.83 – 1.20; P = .60).
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However, weekly paclitaxel was associated with a 3.9-month longer progression-free survival than paclitaxel administered every 3 weeks among patients who did not receive bevacizumab (14.2 vs 10.3 months; HR, 0.62; 95% CI, 0.40 – 0.95; P = .03).
In terms of safety, patients who received weekly paclitaxel experienced a higher incidence of grade 3 or 4 anemia and grade 2 to 4 sensory neuropathy than those who received it every 3 weeks, while patients who received paclitaxel every 3 weeks had a higher rate of grade 3 or 4 neutropenia.
- Chan JK, Brady MF, Penson RT, et al. Weekly vs. every-3-week paclitaxel and carboplatin for ovarian cancer. N Engl J Med. 2016; 374:738-748.